Two-Week Direct-Acting Antiviral Prophylaxis for Kidney Transplantation From Donors With Hepatitis C Viremia to Recipients Without Hepatitis C Viremia: A Small Uncontrolled Trial
Authors: Niraj M. Desai, Sherry G. Leung, Jennifer D. Motter, Dorry L. Segev, Daniel Warren, Christine M. Durand
Journal: Annals of Internal Medicine (2023)

Letters28 November 2023Two-Week Direct-Acting Antiviral Prophylaxis for Kidney Transplantation From Donors With Hepatitis C Viremia to Recipients Without Hepatitis C Viremia: A Small Uncontrolled TrialNiraj M. Desai, MD, Sherry G. Leung, BA, Jennifer D. Motter, MHS, Dorry L. Segev, MD, PhD, Daniel Warren, PhD, Christine M. Durand, MDNiraj M. Desai, MDDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, Sherry G. Leung, BADepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, Jennifer D. Motter, MHSDepartment of Surgery, New York University Grossman School of Medicine, New York, New York, Dorry L. Segev, MD, PhDDepartment of Surgery and Department of Population Health, New York University Grossman School of Medicine, New York, New York, Daniel Warren, PhDDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, Christine M. Durand, MDDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MarylandAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-2682 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: The use of organs from donors with hepatitis C virus (HCV) viremia for recipients without HCV viremia (HCV D+/R−) with direct-acting antiviral (DAA) prophylaxis can increase access to kidney transplant (KT). However, the optimal duration of prophylaxis is unknown.Objective: To investigate the safety and efficacy of 2-week DAA prophylaxis for HCV D+/R− KT (ClincalTrials.gov: NCT04575896).Methods and Findings: We performed a small uncontrolled trial of 10 HCV D+/R− KTs at Johns Hopkins, approved by the institutional review board. Eligible candidates were aged 18 years or older, had negative HCV RNA results, and were without HIV or active hepatitis ...References1. Durand CM, Bowring MG, Brown DM, et al. Direct-acting antiviral prophylaxis in kidney transplantation from hepatitis C virus–infected donors to noninfected recipients. An open-label nonrandomized trial. Ann Intern Med. 2018;168:533-540. [PMID: 29507971] doi:10.7326/M17-2871 LinkGoogle Scholar2. Durand CM, Barnaba B, Yu S, et al. Four-week direct-acting antiviral prophylaxis for kidney transplantation from hepatitis C–viremic donors to hepatitis C–negative recipients. An open-label nonrandomized study. Ann Intern Med. 2021;174:137-138. [PMID: 32894697] doi:10.7326/M20-1468 LinkGoogle Scholar3. Molnar MZ, Nair S, Cseprekal O, et al. Transplantation of kidneys from hepatitis C–infected donors to hepatitis C–negative recipients: single center experience. Am J Transplant. 2019;19:3046-3057. [PMID: 31306549] doi:10.1111/ajt.15530 CrossrefMedlineGoogle Scholar4. Gupta G, Yakubu I, Bhati CS, et al. Ultra-short duration direct acting antiviral prophylaxis to prevent virus transmission from hepatitis C viremic donors to hepatitis C negative kidney transplant recipients. Am J Transplant. 2020;20:739-751. [PMID: 31652392] doi:10.1111/ajt.15664 CrossrefMedlineGoogle Scholar5. Gupta G, Yakubu I, Zhang Y, et al. Outcomes of short-duration antiviral prophylaxis for hepatitis C positive donor kidney transplants. Am J Transplant. 2021;21:3734-3742. [PMID: 34212479] doi:10.1111/ajt.16747 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Niraj M. Desai, MD; Sherry G. Leung, BA; Jennifer D. Motter, MHS; Dorry L. Segev, MD, PhD; Daniel Warren, PhD; Christine M. Durand, MDAffiliations: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MarylandDepartment of Surgery, New York University Grossman School of Medicine, New York, New YorkDepartment of Surgery and Department of Population Health, New York University Grossman School of Medicine, New York, New YorkDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MarylandFinancial Support: By the National Institute of Allergy and Infectious Diseases (U01AI157931 to Drs. Desai, Segev, and Durand and K24AI144954 to Dr. Segev). A private donor provided funding to purchase glecaprevir–pibrentasvir.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-2682.Reproducible Research Statement:Study protocol, statistical code, and data set: Available on request from Dr. Durand (e-mail, christinedurand@jhmi.edu) with appropriate data use agreements in place.Corresponding Author: Christine M. Durand, MD, Department of Medicine, Johns Hopkins University School of Medicine, 2000 East Monument Street, Baltimore, MD 21205; e-mail, christinedurand@jhmi.edu; and Niraj M. Desai, MD, Department of Surgery, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Ross 771, Baltimore, MD 21205; e-mail, ndesai13@jhmi.edu.This article was published at Annals.org on 28 November 2023. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics December 2023Volume 176, Issue 12 Page: 1682-1684 Keywords Adverse events Clinical trials Estimated glomerular filtration rate Liver transplantation Prophylaxis Renal transplantation RNA Safety Surgery Viremia ePublished: 28 November 2023 Issue Published: December 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...